More than 90 Americans died between 2009 and 2022, within three weeks of undergoing cosmetic surgery in the Dominican Republic, U.S. health officials said Thursday.
Ninety-two percent of a specific subset of the deaths involved Brazilian butt lift surgery.
The BBL procedure harvests fat by liposuction, before it’s purified, then reinjected into the buttocks.
Autopsy reports for 20 deaths found 11 were the result of fatty tissue entering the bloodstream, where it blocked key arteries or veins.
CDC Specifics on a Subset
- 29 of the deaths occurred in 2019 and 2020.
- For 24 of these deaths (83%), medical records were available.
- All 24 were women, aged 26-61.
- 22 of 23 pts. for whom BMI data was available were “overweight” or “obese” (96%).
- All 24 patients had liposuction (100%) .
- 22 had gluteal fat transfer surgery (92%).
- 14 had a tummy tuck (58%).
- Between 2-4 surgeries were performed on each of the 24 deceased, with a mean of 3.
Total Deceased, 2009-2022
The deaths include 92 women and one man, and more than half (52) occurred in 2019-2022.
An average of 6.64 deaths occurred per year from 2009-2022, with a dramatic increase in the latter years.
Deaths increased from a mean of 4.1 per year from 2009-2018, to a mean of 13 per year from 2019 to 2022.
Deaths per year ranged from a low of 1 in 2009 to a high of 17 in 2020, authorities found.
Risk factors isolated included undergoing multiple surgical procedures at the same time, and obesity.
Most board-certified plastic surgeons set personal BMI limits for their patients, above which they won’t operate.
The CDC began its investigation after the U.S. Embassy in the Dominican Republic reached out to the U.S. regulatory agency.
The CDC then conducted its investigation with the Dominican Ministry of Health.
The agency defined the cases it considered in its investigation as deaths of a U.S. citizen that occurred within three weeks of undergoing cosmetic surgery in the Dominican Republic during the years 2009 to 2022, both the surgery and the patient’s death having occurred in the Dominican Republic.
The CDC said the fact infections occur after cosmetic surgery is already widely-known, but that deaths specifically have been “rarely reported.”
It advises persons interested in traveling for surgery or undergoing surgery at all to consult their providers about risk and other factors including the “importance of preoperative patient evaluation and the potential danger of performing multiple cosmetic procedures in one operation.”
Global plastic surgery statistics include no specific procedure counts for the Dominican Republic.
The Dominican Republic Ministry of Health said it is aware of 70–80 cosmetic surgery clinics in the country, but was unsure how many of them treat medical tourists, as well as how many private practice surgeons might be operating outside of a clinical setting.
In 2022, the country was not included on a list of the 12 countries worldwide that receive the most foreign plastic surgery patients.